AccountId: 011433970860
ContactId: f5ef6025-3930-42fa-bbc1-dc4604df1a92
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 291429 ms
Total Talk Time (AGENT): 104354 ms
Total Talk Time (CUSTOMER): 94422 ms
Interruptions: 1
Overall Sentiment: AGENT=0.5, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/19/f5ef6025-3930-42fa-bbc1-dc4604df1a92_20250519T18:19_UTC.wav
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[AGENT][NEUTRAL] Calling APL, my name is [PII]. How can I assist you today?
[CUSTOMER][NEUTRAL] Uh hi [PII]. My name is [PII]. I'm calling from the provider's office to check on the claim status.
[AGENT][POSITIVE] I'd be happy to assist with claim status today, [PII] if I can get a good call back number for you.
[CUSTOMER][NEUTRAL] Uh, sure. My callback number is [PII]. It's a direct line.
[AGENT][NEUTRAL] And what is the policy number?
[CUSTOMER][NEUTRAL] Sure
[CUSTOMER][NEUTRAL] Uh, the member ID is 02538256.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] Uh, the patient name is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that information. Please be advised the verification of coverage is not a guarantee of payment. I do show the policy is currently active. Effective date is [PII]. And are you qualified inpatient or outpatient benefits?
[CUSTOMER][NEUTRAL] Uh, inpatient time looking for Prime status.
[AGENT][NEUTRAL] Oh, I'm sorry, what's the date of service?
[CUSTOMER][NEUTRAL] Uh, the data services [PII].
[AGENT][NEUTRAL] And your tax ID?
[CUSTOMER][NEUTRAL] Uh, the tax ID number is [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] All right, one moment.
[AGENT][NEUTRAL] OK, I'm showing that uh payment was made in the amount of $1,955 on that claim.
[CUSTOMER][NEUTRAL] OK, um, can I have the claim number?
[AGENT][NEUTRAL] Claim number is 358-8992.
[CUSTOMER][NEUTRAL] May I know the receipt date of the client?
[AGENT][NEUTRAL] Claim was received on [PII]. Can I paid on [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Um, may I know how the claim was paid, whether it is paid through a your check?
[AGENT][NEUTRAL] Um, it was a check.
[CUSTOMER][NEUTRAL] Uh, can I have the check number?
[AGENT][NEUTRAL] Check number is 203-917-1 and the check cleared on [PII].
[CUSTOMER][NEUTRAL] And can I have the amount of this plan?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Allowed to go.
[AGENT][NEUTRAL] Well, it wasn't an allowed amount. It was just that was all that they had left on their yearly benefit.
[AGENT][NEUTRAL] So that's all we paid. So the rest, I'm sorry, go ahead.
[CUSTOMER][NEUTRAL] Yeah, um, how much is to pay the amount?
[CUSTOMER][NEUTRAL] Uh, how much is the paid amount in this claim?
[AGENT][NEUTRAL] $1,955.
[CUSTOMER][NEUTRAL] To doctors, and is there any patient responsibility in this time?
[AGENT][NEUTRAL] It would be whatever we didn't cover, whatever we didn't pay.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 11 2nd.
[CUSTOMER][NEUTRAL] And may I know where the check was issued to the mailing address? Do you have that information?
[AGENT][NEUTRAL] Carolina urology partners, excuse me, [PII] and it cleared on [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Thank you for that. And if possible, could you please fax us explanation of benefits.
[AGENT][NEUTRAL] OK, and what is that fax number?
[CUSTOMER][NEUTRAL] Uh, the fax number is 201627.
[CUSTOMER][NEUTRAL] 3 663.
[AGENT][NEUTRAL] 3673.
[AGENT][NEUTRAL] And to whose attention?
[CUSTOMER][NEUTRAL] 3663.
[AGENT][NEUTRAL] 0 36.
[CUSTOMER][NEUTRAL] Oh sorry, the fax number again is.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 201627-3663.
[AGENT][NEUTRAL] OK, and to whose attention?
[CUSTOMER][NEUTRAL] You can keep it myself, [PII].
[AGENT][POSITIVE] Alright, you should receive that within the next 10 to 15 minutes. Was there anything else I can assist with today?
[CUSTOMER][NEUTRAL] Can I have the call reference number?
[AGENT][NEUTRAL] Reference is just my name [PII], last initial [PII] [PII], and the date and time of the call.
[CUSTOMER][POSITIVE] OK, thanks for that information, [PII]. Have a wonderful day.
[AGENT][POSITIVE] Thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] Yeah. Bye-bye.